Although women receive nearly half of all doctoral degrees and show a high interest in academic careers, this early pipeline is leaky since few women advance to the higher professorial ranks or leadership positions. The challenges of life course events, particularly childbearing and childrearing, is likely to lead to women's slower career advancement and premature dropout from academic careers. These challenges are even more complex for women in academic medicine due to long training paths, unpredictable work hours, no summer release time, and the requirement to develop and maintain focused expertise in both clinical and research areas, among other demands. Yet, there is little data on how balancing family life affects women in academic medicine or how work-life balance can be facilitated. In this application, we propose to test the hypotheses that a) the challenges of balancing career and family life disproportionately affect women in academic medicine, leading to slower career advancement and/or dropout from academia, b) these effects can be offset by an accelerator intervention for family-friendly policies which includes increasing policy awareness and their equitable use, and c) this intervention will lead to increased personal and professional satisfaction, and improved recruitment, retention, and career performance. The School of Medicine at the University of California, Davis will be used as a prototype and compared with other UC Davis health science and biological science schools. The proposed specific aims are: I. To survey both women faculty and academic leaders pre-intervention about satisfaction and awareness of / intent to use specific career flexibility options. II. To implement an 'Accelerator Intervention' designed to accelerate awareness of, access to, and equitable use of family-friendly policies, and to assess its impact over a 3-year follow-up period in terms of changes in objective professional outcomes, awareness of and use of options, and personal satisfaction. III. To explore the degree to which personal and professional characteristics of individual faculty members (demographics, rank, series, specialty, etc.) affect their objective performance during the intervention, their awareness and equitable use of options, and their career satisfaction. The proposed studies could lead to a new successful strategy for change targeted to improving the retention and advancement of women in academic medical careers that is exportable to other institutions. PUBLIC HEALTH RELEVANCE: As more women enter science careers, interest in the ways in which the careers of men and women scientists differ has increased. Female participation in science contributes to scientific discourse, enriches scientific thinking and provides new perspective. The participation of women in academic health science and medicine has fueled the interest in gender-based medicine and related new discoveries. Women academics also serve as important role models and mentors for women trainees. There are, however, significant gender differences in career trajectories and outcomes with many more women than men showing slower progression through the academic ranks, not attaining leadership positions, or ultimately abandoning academic health science careers. The challenges of balancing family and career are common reasons for these differences, particularly for women in academic medicine. The proposed studies of this application will investigate the effects of an 'Accelerator Intervention' for family-friendly policies and career flexibility on women's careers in academic medicine with an emphasis on use of these policies, career advancement, and professional satisfaction.